Recognition and initial management of seriously ill children

Question 1

What is compensated respiratory failure?

Answer 1

Increased resp rate and effort in order to maintain normal oxygen saturations

Question 2

What is compensated cardiac failure?

Answer 2

In order to maintain blood pressure there is an increase in heart rate and systemic vascular resistance. Can cause a change in peripheral perfusion

Question 3

What are common causes of circulatory failure in children?

Answer 3

Diarrhoea. Vomiting and Sepsis

Question 4

What are important things to consider when assessing a child?

Answer 4

Their PEWS score
Their current engagement
Their parents account of what they are normally like
How unwell does the child look

Question 5

What are key things to consider with airway?

Answer 5

Is the child talking/crying normally
What is their level of consciousness
Is there any stridor present

Question 6

What are key things to look for when assessing a childs work of breathing?

Answer 6

Resp rate
Use of accessory muscles e.g. intercostal#
Chest expansion and symmetry
Nasal flaring
Head bobbing (infants)
Positioning- tripod
Anxiousness
Exhaustion- key concern

Question 7

What parameters should be assessed in Circulation?

Answer 7

HR, rhythm and regularity
Pulse volume
CRT
Skin temperature
Urine output
Consciousness level
BP- hypotension is a late sign

Question 8

What are some causes of reduced consciousness

Answer 8

Resp failure
Circulatory failure
Hypoglycaemia
Postictal state
Raised intracranial pressure- post head injury
Drugs
Metabolic disorders

Question 9

What are signs of a decerebrate

Answer 9

Extended arms
Pronated arms
Flexed wrists
Adducted limbs

Question 10

What are signs of decorticate condition?

Answer 10

Adducted limbs
Legs internally rotated